Several years ago I had a client with a very specific training dilemma. In terms of finding a solution, his dilemma almost stumped me. But once again, the solution came by thinking of program design first and workout structure, strategy and application as it fit into his specific dilemma.

Let me say from the onset that any time medical issues are a factor for a trainee’s fitness regimen, then the best Coaches will ALWAYS defer to the medical experts first and foremost. And this is always important to keep in mind.

Read Part 1: Solving a “Time Crunch” Workout Dilemma with Program Design

Here is the example and the dilemma:

I had a client with an extensive background in pumping iron and weight training. He knew his way around the gym to be sure, not that he was a competitor or anything like that. He just always liked training with weights.

Before he came to me to sign up for Coaching, he was already going along just fine in his training – usually going from a 5 days program to a 6 days program of mine. And he was doing well.

Then a medical issue struck.

He had a flare up of an autoimmune disease that left him with chronic fatigue. He went weeks and months barely being able to get out of bed. And all the meds he was taking for treatment had side effects that made the chronic fatigue even worse. Laymen would refer to his situation as “adrenal fatigue” or “adrenal burnout” but his situation was certainly medical, not speculative.

And while his situation was not life threatening and he wasn’t going to die, he certainly wasn’t living either; not compared to the life he previously had anyway.

But over the course of months, his treatment worked and he was slowly but surely getting some energy back. Then, he had a heart attack.

And he was back on the shelf again and ordered to rest.

Finally, after months of meds and rest, he was given a medical clearance to ‘exercise’ again. But this ‘exercise’ was merely to walk around the block and stop if he needed to. Through all of this he had learned not to push beyond the medical advice he was given.

It was around this time he contacted me.

After building up his stamina and being able to walk for 30 mins no problem, he was finally given the go ahead that he could start a real exercise regimen again. But he was still on meds that affected his cortisol levels, and affected his blood pressure and such – so, he was given the medical advice that he should exercise no more than 20 minutes per day with weights.

So this was my dilemma to solve:

What kind of workout or program could I assign to someone who is adrenal-compromised, hasn’t worked out in months, and wants to get back to the weights, which his medical team agreed was a good idea for him.

Well, the first thing of course, beyond the obvious assessment is the not so obvious assessment. This particular client had a great background working out with weights. I could count on that experience moving forward. He wasn’t green and starting from scratch when it came to exercises, sets, and reps, and execution.

This was a plus.

But there was still the issue of a 20 minutes exercise window limitation to deal with.

This was a different kind of time-constraint than the one I outlined in my previous Blog article. This time constraint was for specific medical reasons. It wasn’t because the client didn’t have the time because of long work hours or other issues.

This client had access to a fully equipped gym, and generous amounts of time to workout.

But he did not yet have the strength, the health, or the conditioning to do anything beyond this 20 minutes training limitation.

And given that the client wanted to regain lost muscle and conditioning, and given the medical advice he received was that gaining some strength back would be a good thing for his health, then my approach to his dilemma is below

The solution?

“Adrenal-Comeback Support Workouts”

In my files, I call this program “20-minute Adrenal-Comeback Support workouts.” (If you're familiar with my Program Design Masterclass, I always try to name a program after the intent of the program, as much as possible. This is important for using them and tweaking them later on with individual clients.)

Let me go through how the program was setup.

* * *

Rules and Considerations

Even with only 20-30 minutes of total time available to work out, the body still requires warm up. It makes sense to take at least 5-7 minutes for “general preparation” work that should include variations of arm swings, legs swings, mild bending and reaching and then one or two warm up sets of the exercise called for on that day – along the lines of my classic GPP for workouts:

And for this particular client, starting from his body being completely deconditioned, a sound GPP like above, could easily be considered as part of his overall conditioning contribution to the workout and the program; especially in these early stages.

About the Program

The accentuation for the workouts within this program is a bodypart and recovery consideration. Since the client has such an extensive background with bodybuilding type training, this could be used to our advantage. Furthermore, more important than the volume of sets within the 20 minutes time limit, is the stimulation and type of stimulation.

So for these workouts we could tactically employ surfing the reps curve (6-8 reps to 20 reps) and this would be far more important and more efficient than the number of sets completed within the 20 minutes limitation.

Next, in terms of overall muscle stimulation, compound movements, give us more ‘bang for our buck’, so to speak –as long as those movements are not too ballistic in nature nor too metabolic; but typical bodybuilding exercises were still the best choice as well.  Furthermore, I couldn’t risk putting the client in too deep of an oxygen debt either, as his systemic recovery from chronic fatigue was also an important variable for consideration.

I came up with a 5 days rotational workout structure, but those 5 days were not spread out over a typical 7 day week. Instead, he was instructed to follow a rotation as follows:

  • 4 days on
  • 1 day off
  • 3 days on
  • 1 day off

And, with only 20 mins to workout, just like in the previous blog article, one single exercise per workout made the most sense. And don’t forget, for this client, supersets and biplexes and such were out of the question for day to day to consideration, because his systemic recovery could not be compromised. (Therefore, he only had assigned a very simple, and non-demanding mini-circuit once over the 5 day rotation)

Tactically, my instruction to the client was to emphasize under-training with complete recovery between sets. So, if he only completed 3-5 working sets per session, then this would have to be sufficient.

The workouts were then broken down to this format:

Workout Split

Day 1: Any chest press or chest fly motion.
…as many sets as possible post warm up

Day 2: Any squat, lunge, or leg press variation.
…as many sets as possible post warm up

Day 3: Any shoulder press variation or dumbbell side laterals, standing or seated.
…as many sets as possible post warm up

Day 4: Any rowing or pulldown variation.
…as many sets as possible post warm up

Day 5: Mini-Circuit Conditioning Day, rotate between two Mini Circuit options*

 

* Mini Circuit Options

Circuit Option 1:

  • 1a) BW squats X’s 15-20 then
  • 1b) any sit up variation X’s 15-20 then
  • 1c) pushups (using pushups bars of course) X’s 10-15

Circuit Option 2:

  • 1a) BW alternating reverse lunges or leg press X’s 15-20 then
  • 1b) pushups X’s 15-20 then
  • 1c) any leg raise variation X’s 15-20

This sequence was to be performed as a mini-circuit with as much rest as necessary between each round – as many sets as possible post warm up.

Rep Range Rotation

Above, I mentioned surfing the reps curve.

The client was instructed to rotate his reps range each workout and cycle the reps ranges accordingly. So workout #1 he would stick to 6-8 reps, workout #2 he would stick to 10-12 reps, workout #3 he would stick to 15-20 reps, and other than Day 5, he would just keep rotating these reps schemes and stick to them. This way during each rotation, he had one heavier load emphasis, one medium load emphasis, and one lighter load, pumping cadence emphasis. And he was instructed to choose a load that challenged him within these reps schemes, but without training to failure.

It was very important for the client to stick the these rep range rotations, because given his situation, too many frequent heavier loads, low reps workouts would be harder on his CNS and that could compromise his systemic recovery from a medical standpoint.

So you can see a lot of thinking had to go into structuring a very simple but effective approach to short workouts that could focus on gradual reconditioning to weight training, while counting on muscle memory, but still NOT risk compromising his recovery and sending him backwards.

Hopefully you can tell from all of this that a typical ‘hardcore’ approach to ‘get back at it’ would have surely done him in.

A typical rotation for him then would have looked something like this:

Exercise Rep Range Sets
Day 1 Seated machine chest press 6-8 as many sets as possible within 20 mins
Day 2 Horizontal leg press machine 10-12 as many sets as possible within 20 mins
Day 3 Machine side lateral raises 15-20 as many sets as possible within 20 mins
Day 4 Reverse grip pulldowns 6-8 as many sets as possible within 20 mins
Off.
Day 5 Mini-Circuit #1
Day 1 Incline DB press 10-12 as many sets as possible within 20 mins
Day 2 DB squats 15-20 as many sets as possible within 20 mins
Off.
Day 3 Seated shoulder press 6-8 as many sets as possible within 20 mins
Day 4 Seated cable rows 10-12 as many sets as possible within 20 mins
Day 5 Mini-circuit #2
Day 1 Seated machine chest flyes 15-20 as many sets as possible within 20 mins
Off.
[…and then continue as above.]

So, as you can see, the bodypart being hit after a day off rotates, as do the rep ranges for each bodypart as well as he follows the sequence. Program design, even when it’s simple, is about more than slapping together exercises.

You also notice no training for biceps and triceps here. That is a deliberate decision as well. There just would be too little of a payoff for reconditioning to bring arm training into this sequence at this point.

Conclusion

As you can probably guess: this program and application would be of no use to 99 out of 100 trainees!

But for this specific trainee, this was the right protocol at the right time for the right reason, and this protocol was the difference between him getting his fitness and his health back, vs. setting him back even further by doing too much too soon.

So with all that in mind, you can imagine why this specific program – as simple as it may seem – is one of the programs I’ve designed that I am most proud of – even though it has no general assignment value beyond this particular trainee for this particular dilemma.

The key lesson in these training dilemma articles goes back to a fundamental program design principle I outlined over 30 years ago. The first rule of program design no matter what is this: ‘the program fits the client, the client does not fit the program.’

Hopefully, this article gives you effective insights into program design variables and essentials; whether this is to instruct your own training moving forward, or if you are a Coach or trainer looking to help others.

If you want to make a deeper dive into program design, I suggest my Program Design Master Class Course.